Spinal Stenosis


What is spinal stenosis?

Spinal stenosis describes any narrowing in the spinal canal, nerve root canals and the neural foramina along the spine. There are two types of stenosis with the first being congenital or developmental stenosis where the canal diameter is too small for the nerve roots and spinal cord.

Acquired stenosis, the second type, is more common and develops through the long-term processes of degeneration of the three-joint complex that consists of the intervertebral disc, the inferior and superior vertebral bodies and facet joints. It is not uncommon for people over thirty to develop synovitis or inflammation of the synovial joints along the spine. Osteophytes can form and cause narrowing of the foramina, root canals, and spinal canal. Herniated discs and slipped discs can also participate in the biomechanical degeneration that gradually loosens the facet joints and increases spine instability that sets the stage for the development of spinal stenosis. The narrowing over time will place pressure on the neural system and impede blood flow which results in ischemic neuritis.

When does spinal stenosis usually appear and what are its symptoms?
Generally, acquired stenosis is not found in the young. On average it appears in the seventies and presents with sudden symptoms of pain in the lower back, buttocks, thighs and calves. Unlike a herniated disc, the radiating pain is bilateral and appears in both legs. Individuals also complain of increased pain in the back and leg with standing or extensive walking. Bladder issues can develop as the condition worsens. During a physical examination, the natural curve of the lower spine may appear to be flattened, and the range of motion in the back is limited.
How is spinal stenosis treated?
Like foraminal stenosis, spinal stenosis is caused by compressing a nerve. Fortunately, there are conservative, nonsurgical treatments that will naturally decompress the nerve and relieve the insidious pain. Dr. Nourian will develop an opioid-free treatment program that fits your lifestyle. It may include physical therapy which may focus on posture, yoga and acupuncture. To reduce pain, Dr. Nourian may suggest using a transcutaneous electric nerve stimulator (TENS). For acute pain, he may recommend epidural steroids.

Patients whose pain has not responded to nonsurgical treatments and who have lifestyle-limiting complaints may require surgery. At this point, Dr. Nourian may suggest medical imaging studies that may include X-rays, CT scans with myelography, MRI and electrodiagnostic scanning.

The objective of spinal stenosis surgery is to remove the material that is pressing on the spinal cord and nerve roots. Your surgeon has numerous surgical options which he or she will discuss with you thoroughly before proceeding. The most common treatments are decompressive laminectomy, microlaminectomy, medial facetectomy and microfacetectomy and in a few cases, spinal fusion.

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What Patients Think About Dr. Nourian

Awesome awesome doctor!!!very nice to all his patient! Dr. Nourian is very kind and caring. A very pleasant man and easy to communicate with. He saw my son when he injured his hip and He took extra good care of him. After 2 wks he was able to resume sports. He’s not only a very good orthopedic surgeon but also an amazing Spine doctor. He always make sure he always gets the job done. 2 Thumbs up to this Doctor!!!??

Regz Ramos


Dr. Nourian was fantastic! He was able to alleviate my back pain. I would recommend him to anyone

Nikesh Patel


Dr. Nourian is the best. His bedside manner is friendly and professional and his staff is excellent. I went to see him after a terrible whiplash injury when I rear-ended while driving. After receiving my MRI results, the doctor was quick to reach out and went over my options with me. He really cares about his patients.

Michelle Sadighpour Shophet


Dr. Nourian is an outstanding physician. I injured my back while exercising recently. I went to see him, and he explained my injury to me in detail. He told me that my injury would most likely heal without surgery, but if I needed surgery in the future he would get me through it. He is honest, intelligent, and forthcoming. I am thankful for him as my spine physician.

Michael Broukhim


Dr. Nourian was absolutely fantastic. I was struggling with intense lower back pain. He took his time 40 minutes to be exact to see me and review everything with me after another follow up we decided to do surgery. Thank god!!! I’m back to working out, picking up my child, and living my best life. I was so hesitant to do surgery but he was a true god send. He would call me weekly to see how I’m doing.

Sara Sadig


Dr. Nourian is smart, caring, attentive and super knowledgeable. I highly recommend him as an orthopedic surgeon!

Sharon Darouvar Greiner


Great with patients and consciences of patient’s time as well as needs. He will spend time to assure the patients with respect to treatment plan and follow-up was amazing with my auntie’s back issues.

Connie Esparza


An extremely knowledgeable doctor with wonderful bedside manner. He clearly explained every step of the procedure and eased all my worries. My back is feeling great thanks to Doctor Nourian

Ashley Sadig


After seeing three doctors and all of them saying I should operate Dr Nourian was able to address and issue without and surgery. I got an epidural and did physical therapy and I’m able to run around with my grand child. He’s truly a gem. Everyone at the office was friendly and supportive.

Katrin Sadighpour


Dr. Nurian explained everything very well and preformed the surgery exactly as planned. I woke up pain free and the surgery pain was gone in five days. Could not give him enough praise.

Wade Savage